Healthcare Provider Details

I. General information

NPI: 1891970489
Provider Name (Legal Business Name): DAVID P HURLEY JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2008
Last Update Date: 01/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 MAYWOOD DR
DANVILLE IL
61832-2921
US

IV. Provider business mailing address

60 MAYWOOD DR
DANVILLE IL
61832-2921
US

V. Phone/Fax

Practice location:
  • Phone: 217-474-8531
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: